Printable checklist for your desk
Print this checklist, mark your own dates, and bring it to our meeting or your Medicare counselor.
Download the PDF (large print)The short version. Medicare has fixed enrollment windows, and missing them can add a permanent penalty to your premiums. Higher income two years ago can also raise what you pay. Open enrollment for next year's plan runs October 15 to December 7.
2026 costs
| Item | 2026 amount |
|---|---|
| Part B standard monthly premium | $202.90 |
| Part B annual deductible | $283 |
| Part A inpatient hospital deductible (per benefit period) | $1,736 |
| Part A monthly premium, if you do not have enough work credits | $565, or $311 with 30 to 39 credits |
| Part D annual out-of-pocket cap | $2,100 |
IRMAA: when income raises the premium
If your income is above certain thresholds, you pay an income-related monthly adjustment amount (IRMAA) on top of the standard Part B premium and on top of your Part D plan premium. For 2026 the Social Security Administration generally uses your 2024 tax return. [1, 3]
| Income, single | Income, married filing jointly | Total Part B per month | Part D added per month |
|---|---|---|---|
| $109,000 or less | $218,000 or less | $202.90 | $0 |
| Over $109,000 to $137,000 | Over $218,000 to $274,000 | $284.10 | $14.50 |
| Over $137,000 to $171,000 | Over $274,000 to $342,000 | $405.80 | $37.50 |
| Over $171,000 to $205,000 | Over $342,000 to $410,000 | $527.50 | $60.40 |
| Over $205,000 to under $500,000 | Over $410,000 to under $750,000 | $649.20 | $83.30 |
| $500,000 or more | $750,000 or more | $689.90 | $91.00 |
Married filing separately and living with your spouse: $109,000 or less pays the standard amount; over $109,000 to under $391,000 pays $649.20 for Part B and $83.30 for Part D; $391,000 or more pays $689.90 and $91.00. The tiers are cliffs, so one dollar over a line moves you up a whole tier. [1, 3]
If your income dropped because of a life-changing event such as marriage, divorce, a spouse's death, stopping work or cutting hours, you can ask Social Security to use a more recent year with Form SSA-44. [4]
The enrollment windows
| Window | What to know |
|---|---|
| Initial enrollment | Seven months: the three months before your 65th birthday month, the birthday month, and the three months after. |
| General enrollment | January 1 to March 31 each year, if you missed your initial window. |
| Special enrollment (working past 65) | If you have coverage through your own or a spouse's current employer, you have eight months after that work or coverage ends. COBRA and retiree coverage do not count. |
| Open enrollment | October 15 to December 7: change Medicare Advantage or Part D plans for next year. |
| Medicare Advantage open enrollment | January 1 to March 31: one change to another Medicare Advantage plan or back to Original Medicare. |
| Medigap open enrollment | A one-time six-month window starting when you are 65 or older and have Part B. |
Penalties for missing the window
- Part B: 10% added to your premium for each full 12-month period you could have had it but did not. Generally it lasts as long as you have Part B. [9]
- Part D: 1% of the national base premium ($38.99 in 2026) for each month you went without creditable drug coverage, after a gap of 63 days or more. [9]
Will I be enrolled automatically?
If you already get Social Security or Railroad Retirement benefits at least four months before you turn 65, you are enrolled in Parts A and B automatically. If you are not yet receiving benefits, you must apply yourself. You can decline Part B if you have other coverage. [10]
If you have a Health Savings Account
You cannot contribute to an HSA once you are enrolled in Medicare, and Part A can go back up to six months, so it is wise to stop HSA contributions about six months before you apply. [11]
Questions worth asking
- When is my initial enrollment window, and do I have employer coverage that lets me delay Part B?
- What will my premiums be after income-related amounts, based on my tax return from two years ago?
- Do I have a Health Savings Account that needs an end date for contributions?
- Have I compared my current plan with the alternatives before December 7?
- Could a Roth conversion or large withdrawal push me over a threshold two years from now?
Frequently asked questions
What is the 2026 Medicare Part B premium?
The standard monthly Part B premium is $202.90, with an annual deductible of $283.
What is IRMAA?
The income-related monthly adjustment amount, an extra charge on Part B and Part D for people above certain income levels. For 2026, Social Security generally uses your 2024 tax return.
When can I change my Medicare Advantage or Part D plan?
During open enrollment, October 15 to December 7, for next year's plan. Medicare Advantage open enrollment also runs January 1 to March 31 for one change.
Sources and review notes
- CMS: 2026 Medicare Parts A and B premiums and deductibles
- Medicare.gov: Medicare costs
- Social Security: Medicare premiums, income-related monthly adjustment
- Social Security: Request a reduction in your income-related monthly adjustment
- Medicare.gov: When does Medicare coverage start?
- Medicare.gov: Working past 65
- Medicare.gov: Open enrollment
- Medicare.gov: When to buy Medigap
- Medicare.gov: Avoid late enrollment penalties
- Medicare.gov: Before you turn 65
- Medicare.gov: Working past 65, including HSA guidance
General education, not individualized investment, tax, or legal advice. Discuss tax decisions with your tax professional, and recheck annual limits before using this page for another tax year.